Provider Demographics
NPI:1871909200
Name:DANGELMAIER, RUTH (PHD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:
Last Name:DANGELMAIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3318
Mailing Address - Country:US
Mailing Address - Phone:253-212-0750
Mailing Address - Fax:253-507-4613
Practice Address - Street 1:2111 N 30TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3318
Practice Address - Country:US
Practice Address - Phone:253-212-0750
Practice Address - Fax:253-507-4613
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-07
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00003887103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical